Bone marrow necrosis secondary to imatinib usage, mimicking spinal metastasis on magnetic resonance imaging and FDG-PET/CT

Imatinib mesylate has become the treatment of choice for gastrointestinal stromal tumors (GISTs) and has made a revolutionary impact on survival rates. Bone marrow necrosis is a very rare adverse event in malignant GIST. Bone metastases are also rarely encountered in the setting of this disease. The...

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Bibliographic Details
Published inJournal of neurosurgery. Spine Vol. 16; no. 1; p. 57
Main Authors Aras, Yavuz, Akcakaya, Mehmet Osman, Unal, Seher N, Bilgic, Bilge, Unal, Omer Faruk
Format Journal Article
LanguageEnglish
Published United States 01.01.2012
Subjects
Aged
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Benzamides
Bone Marrow - pathology
Bone Marrow Diseases - chemically induced
Bone Marrow Diseases - pathology
Diagnosis, Differential
Female
Gastrointestinal Neoplasms - drug therapy
Gastrointestinal Stromal Tumors - drug therapy
Humans
Imatinib Mesylate
Magnetic Resonance Imaging
Multimodal Imaging
Necrosis - chemically induced
Necrosis - pathology
Piperazines - adverse effects
Piperazines - therapeutic use
Positron-Emission Tomography
Pyrimidines - adverse effects
Pyrimidines - therapeutic use
Spinal Neoplasms - secondary
Tomography, X-Ray Computed
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Summary:Imatinib mesylate has become the treatment of choice for gastrointestinal stromal tumors (GISTs) and has made a revolutionary impact on survival rates. Bone marrow necrosis is a very rare adverse event in malignant GIST. Bone metastases are also rarely encountered in the setting of this disease. The authors report on a patient with malignant GIST who developed a bone lesion, mimicking spinal metastasis on both MR imaging and FDG-PET/CT. Corpectomy and anterior fusion was performed, but the pathology report was consistent with bone marrow necrosis. Radiological and clinical similarities made the distinction between metastasis and bone marrow necrosis challenging for the treating physicians. Instead of radical surgical excision, more conservative methods such as percutaneous or endoscopic bone biopsies may be more useful for pathological confirmation, even though investigations such as MR imaging and FDG-PET/CT indicate metastatic disease.
ISSN:1547-5646
DOI:10.3171/2011.9.spine11401